HCPCS Code: L6000
Short Description: Part hand thumb rem
Long Description: Partial hand, thumb remaining
HCPCS Code: L6010
Short Description: Part hand little/ring
Long Description: Partial hand, little and/or ring finger remaining
HCPCS Code: L6020
Short Description: Part hand no fingers
Long Description: Partial hand, no finger remaining
HCPCS Code: L6025
Short Description: Part hand disart myoelectric
Long Description: Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device
HCPCS Code: L6026
Short Description: Part hand myo exclu term dev
Long Description: Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)
HCPCS Code: L6050
Short Description: Wrst mld sck flx hng tri pad
Long Description: Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad
HCPCS Code: L6055
Short Description: Wrst mold sock w/exp interfa
Long Description: Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad
HCPCS Code: L6100
Short Description: Elb mold sock flex hinge pad
Long Description: Below elbow, molded socket, flexible elbow hinge, triceps pad
HCPCS Code: L6110
Short Description: Elbow mold sock suspension t
Long Description: Below elbow, molded socket, (muenster or northwestern suspension types)
HCPCS Code: L6120
Short Description: Elbow mold doub splt soc ste
Long Description: Below elbow, molded double wall split socket, step-up hinges, half cuff
HCPCS Code: L6130
Short Description: Elbow stump activated lock h
Long Description: Below elbow, molded double wall split socket, stump activated locking hinge, half cuff
HCPCS Code: L6200
Short Description: Elbow mold outsid lock hinge
Long Description: Elbow disarticulation, molded socket, outside locking hinge, forearm
HCPCS Code: L6205
Short Description: Elbow molded w/ expand inter
Long Description: Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm
HCPCS Code: L6250
Short Description: Elbow inter loc elbow forarm
Long Description: Above elbow, molded double wall socket, internal locking elbow, forearm
HCPCS Code: L6300
Short Description: Shlder disart int lock elbow
Long Description: Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm
HCPCS Code: L6310
Short Description: Shoulder passive restor comp
Long Description: Shoulder disarticulation, passive restoration (complete prosthesis)
HCPCS Code: L6320
Short Description: Shoulder passive restor cap
Long Description: Shoulder disarticulation, passive restoration (shoulder cap only)
HCPCS Code: L6350
Short Description: Thoracic intern lock elbow
Long Description: Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm
HCPCS Code: L6360
Short Description: Thoracic passive restor comp
Long Description: Interscapular thoracic, passive restoration (complete prosthesis)
HCPCS Code: L6370
Short Description: Thoracic passive restor cap
Long Description: Interscapular thoracic, passive restoration (shoulder cap only)
HCPCS Code: L6380
Short Description: Postop dsg cast chg wrst/elb
Long Description: Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow
HCPCS Code: L6382
Short Description: Postop dsg cast chg elb dis/
Long Description: Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow
HCPCS Code: L6384
Short Description: Postop dsg cast chg shlder/t
Long Description: Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic
HCPCS Code: L6386
Short Description: Postop ea cast chg & realign
Long Description: Immediate post surgical or early fitting, each additional cast change and realignment
HCPCS Code: L6388
Short Description: Postop applicat rigid dsg on
Long Description: Immediate post surgical or early fitting, application of rigid dressing only
HCPCS Code: L6400
Short Description: Below elbow prosth tiss shap
Long Description: Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping
HCPCS Code: L6450
Short Description: Elb disart prosth tiss shap
Long Description: Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping
HCPCS Code: L6500
Short Description: Above elbow prosth tiss shap
Long Description: Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping
HCPCS Code: L6550
Short Description: Shldr disar prosth tiss shap
Long Description: Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping
HCPCS Code: L6570
Short Description: Scap thorac prosth tiss shap
Long Description: Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping
HCPCS Code: L6580
Short Description: Wrist/elbow bowden cable mol
Long Description: Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model
HCPCS Code: L6582
Short Description: Wrist/elbow bowden cbl dir f
Long Description: Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed
HCPCS Code: L6584
Short Description: Elbow fair lead cable molded
Long Description: Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model
HCPCS Code: L6586
Short Description: Elbow fair lead cable dir fo
Long Description: Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed
HCPCS Code: L6588
Short Description: Shdr fair lead cable molded
Long Description: Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model
HCPCS Code: L6590
Short Description: Shdr fair lead cable direct
Long Description: Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed
HCPCS Code: L6600
Short Description: Polycentric hinge pair
Long Description: Upper extremity additions, polycentric hinge, pair
HCPCS Code: L6605
Short Description: Single pivot hinge pair
Long Description: Upper extremity additions, single pivot hinge, pair
HCPCS Code: L6610
Short Description: Flexible metal hinge pair
Long Description: Upper extremity additions, flexible metal hinge, pair
HCPCS Code: L6611
Short Description: Additional switch, ext power
Long Description: Addition to upper extremity prosthesis, external powered, additional switch, any type
HCPCS Code: L6615
Short Description: Disconnect locking wrist uni
Long Description: Upper extremity addition, disconnect locking wrist unit
HCPCS Code: L6616
Short Description: Disconnect insert locking wr
Long Description: Upper extremity addition, additional disconnect insert for locking wrist unit, each
HCPCS Code: L6620
Short Description: Flexion/extension wrist unit
Long Description: Upper extremity addition, flexion/extension wrist unit, with or without friction
HCPCS Code: L6621
Short Description: Flex/ext wrist w/wo friction
Long Description: Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device
HCPCS Code: L6623
Short Description: Spring-ass rot wrst w/ latch
Long Description: Upper extremity addition, spring assisted rotational wrist unit with latch release
HCPCS Code: L6624
Short Description: Flex/ext/rotation wrist unit
Long Description: Upper extremity addition, flexion/extension and rotation wrist unit
HCPCS Code: L6625
Short Description: Rotation wrst w/ cable lock
Long Description: Upper extremity addition, rotation wrist unit with cable lock
HCPCS Code: L6628
Short Description: Quick disconn hook adapter o
Long Description: Upper extremity addition, quick disconnect hook adapter, otto bock or equal
HCPCS Code: L6629
Short Description: Lamination collar w/ couplin
Long Description: Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal
HCPCS Code: L6630
Short Description: Stainless steel any wrist
Long Description: Upper extremity addition, stainless steel, any wrist
HCPCS Code: L6632
Short Description: Latex suspension sleeve each
Long Description: Upper extremity addition, latex suspension sleeve, each
HCPCS Code: L6635
Short Description: Lift assist for elbow
Long Description: Upper extremity addition, lift assist for elbow
HCPCS Code: L6637
Short Description: Nudge control elbow lock
Long Description: Upper extremity addition, nudge control elbow lock
HCPCS Code: L6638
Short Description: Elec lock on manual pw elbow
Long Description: Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow
HCPCS Code: L6640
Short Description: Shoulder abduction joint pai
Long Description: Upper extremity additions, shoulder abduction joint, pair
HCPCS Code: L6641
Short Description: Excursion amplifier pulley t
Long Description: Upper extremity addition, excursion amplifier, pulley type
HCPCS Code: L6642
Short Description: Excursion amplifier lever ty
Long Description: Upper extremity addition, excursion amplifier, lever type
HCPCS Code: L6645
Short Description: Shoulder flexion-abduction j
Long Description: Upper extremity addition, shoulder flexion-abduction joint, each
HCPCS Code: L6646
Short Description: Multipo locking shoulder jnt
Long Description: Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system
HCPCS Code: L6647
Short Description: Shoulder lock actuator
Long Description: Upper extremity addition, shoulder lock mechanism, body powered actuator
HCPCS Code: L6648
Short Description: Ext pwrd shlder lock/unlock
Long Description: Upper extremity addition, shoulder lock mechanism, external powered actuator
HCPCS Code: L6650
Short Description: Shoulder universal joint
Long Description: Upper extremity addition, shoulder universal joint, each
HCPCS Code: L6655
Short Description: Standard control cable extra
Long Description: Upper extremity addition, standard control cable, extra
HCPCS Code: L6660
Short Description: Heavy duty control cable
Long Description: Upper extremity addition, heavy duty control cable
HCPCS Code: L6665
Short Description: Teflon or equal cable lining
Long Description: Upper extremity addition, teflon, or equal, cable lining
HCPCS Code: L6670
Short Description: Hook to hand cable adapter
Long Description: Upper extremity addition, hook to hand, cable adapter
HCPCS Code: L6672
Short Description: Harness chest/shlder saddle
Long Description: Upper extremity addition, harness, chest or shoulder, saddle type
HCPCS Code: L6675
Short Description: Harness figure of 8 sing con
Long Description: Upper extremity addition, harness, (e.g., figure of eight type), single cable design
HCPCS Code: L6676
Short Description: Harness figure of 8 dual con
Long Description: Upper extremity addition, harness, (e.g., figure of eight type), dual cable design
HCPCS Code: L6677
Short Description: Ue triple control harness
Long Description: Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow
HCPCS Code: L6680
Short Description: Test sock wrist disart/bel e
Long Description: Upper extremity addition, test socket, wrist disarticulation or below elbow
HCPCS Code: L6682
Short Description: Test sock elbw disart/above
Long Description: Upper extremity addition, test socket, elbow disarticulation or above elbow
HCPCS Code: L6684
Short Description: Test socket shldr disart/tho
Long Description: Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic
HCPCS Code: L6686
Short Description: Suction socket
Long Description: Upper extremity addition, suction socket
HCPCS Code: L6687
Short Description: Frame typ socket bel elbow/w
Long Description: Upper extremity addition, frame type socket, below elbow or wrist disarticulation
HCPCS Code: L6688
Short Description: Frame typ sock above elb/dis
Long Description: Upper extremity addition, frame type socket, above elbow or elbow disarticulation
HCPCS Code: L6689
Short Description: Frame typ socket shoulder di
Long Description: Upper extremity addition, frame type socket, shoulder disarticulation
HCPCS Code: L6690
Short Description: Frame typ sock interscap-tho
Long Description: Upper extremity addition, frame type socket, interscapular-thoracic
HCPCS Code: L6691
Short Description: Removable insert each
Long Description: Upper extremity addition, removable insert, each
HCPCS Code: L6692
Short Description: Silicone gel insert or equal
Long Description: Upper extremity addition, silicone gel insert or equal, each
HCPCS Code: L6693
Short Description: Lockingelbow forearm cntrbal
Long Description: Upper extremity addition, locking elbow, forearm counterbalance
HCPCS Code: L6694
Short Description: Elbow socket ins use w/lock
Long Description: Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism
HCPCS Code: L6695
Short Description: Elbow socket ins use w/o lck
Long Description: Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism
HCPCS Code: L6696
Short Description: Cus elbo skt in for con/atyp
Long Description: Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)
HCPCS Code: L6697
Short Description: Cus elbo skt in not con/atyp
Long Description: Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)
HCPCS Code: L6698
Short Description: Below/above elbow lock mech
Long Description: Addition to upper extremity prosthesis, below elbow/above elbow, lock mechanism, excludes socket insert
HCPCS Code: L6703
Short Description: Term dev, passive hand mitt
Long Description: Terminal device, passive hand/mitt, any material, any size
HCPCS Code: L6704
Short Description: Term dev, sport/rec/work att
Long Description: Terminal device, sport/recreational/work attachment, any material, any size
HCPCS Code: L6706
Short Description: Term dev mech hook vol open
Long Description: Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined
HCPCS Code: L6707
Short Description: Term dev mech hook vol close
Long Description: Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined
HCPCS Code: L6708
Short Description: Term dev mech hand vol open
Long Description: Terminal device, hand, mechanical, voluntary opening, any material, any size
HCPCS Code: L6709
Short Description: Term dev mech hand vol close
Long Description: Terminal device, hand, mechanical, voluntary closing, any material, any size
HCPCS Code: L6711
Short Description: Ped term dev, hook, vol open
Long Description: Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric
HCPCS Code: L6712
Short Description: Ped term dev, hook, vol clos
Long Description: Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric
HCPCS Code: L6713
Short Description: Ped term dev, hand, vol open
Long Description: Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric
HCPCS Code: L6714
Short Description: Ped term dev, hand, vol clos
Long Description: Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric
HCPCS Code: L6715
Short Description: Term device, multi art digit
Long Description: Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement
HCPCS Code: L6721
Short Description: Hook/hand, hvy dty, vol open
Long Description: Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined
HCPCS Code: L6722
Short Description: Hook/hand, hvy dty, vol clos
Long Description: Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined
HCPCS Code: L6805
Short Description: Term dev modifier wrist unit
Long Description: Addition to terminal device, modifier wrist unit
HCPCS Code: L6810
Short Description: Term dev precision pinch dev
Long Description: Addition to terminal device, precision pinch device
HCPCS Code: L6880
Short Description: Elec hand ind art digits
Long Description: Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)
HCPCS Code: L6881
Short Description: Term dev auto grasp feature
Long Description: Automatic grasp feature, addition to upper limb electric prosthetic terminal device
HCPCS Code: L6882
Short Description: Microprocessor control uplmb
Long Description: Microprocessor control feature, addition to upper limb prosthetic terminal device
HCPCS Code: L6883
Short Description: Replc sockt below e/w disa
Long Description: Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power
HCPCS Code: L6884
Short Description: Replc sockt above elbow disa
Long Description: Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power
HCPCS Code: L6885
Short Description: Replc sockt shldr dis/interc
Long Description: Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power
HCPCS Code: L6890
Short Description: Prefab glove for term device
Long Description: Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment
HCPCS Code: L6895
Short Description: Custom glove for term device
Long Description: Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated
HCPCS Code: L6900
Short Description: Hand restorat thumb/1 finger
Long Description: Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining
HCPCS Code: L6905
Short Description: Hand restoration multiple fi
Long Description: Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining
HCPCS Code: L6910
Short Description: Hand restoration no fingers
Long Description: Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining
HCPCS Code: L6915
Short Description: Hand restoration replacmnt g
Long Description: Hand restoration (shading, and measurements included), replacement glove for above
HCPCS Code: L6920
Short Description: Wrist disarticul switch ctrl
Long Description: Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device
HCPCS Code: L6925
Short Description: Wrist disart myoelectronic c
Long Description: Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device
HCPCS Code: L6930
Short Description: Below elbow switch control
Long Description: Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device
HCPCS Code: L6935
Short Description: Below elbow myoelectronic ct
Long Description: Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device
HCPCS Code: L6940
Short Description: Elbow disarticulation switch
Long Description: Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device
HCPCS Code: L6945
Short Description: Elbow disart myoelectronic c
Long Description: Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device
HCPCS Code: L6950
Short Description: Above elbow switch control
Long Description: Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device
HCPCS Code: L6955
Short Description: Above elbow myoelectronic ct
Long Description: Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device
HCPCS Code: L6960
Short Description: Shldr disartic switch contro
Long Description: Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device
HCPCS Code: L6965
Short Description: Shldr disartic myoelectronic
Long Description: Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device
HCPCS Code: L6970
Short Description: Interscapular-thor switch ct
Long Description: Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device
HCPCS Code: L6975
Short Description: Interscap-thor myoelectronic
Long Description: Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device